Characterization of Progesterone Receptor Expression in Intracranial Meningiomas of Patients Treated in a High-Complexity Hospital in Bogota, Colombia.

Background Meningiomas are the single most common brain tumor. The incidence of these tumors increases with age; different studies have shown that meningiomas usually appear after the age of 50. These tumors are more common in women than in men, and women are twice as likely to suffer from the condition. Surgery is the primary form of treatment, which can be curative with complete resection. If the tumor is unresectable or other treatments such as surgery and radiotherapy have failed, hormonal therapy or chemotherapy may be considered. There is limited information about the clinical, demographic, and histopathological characteristics of these tumors in the population of Bogotá, Colombia. Objective To evaluate the expression of progesterone receptors in patients over 18 years old who have been diagnosed with meningiomas in a high-complexity hospital in Bogota, Colombia, and to describe the demographic and histopathological characteristics of these patients. Methods This is a descriptive and retrospective case series. Patients with meningioma who underwent surgical resection at a high-complexity hospital in Bogota, Colombia, from 2016 to 2019 were retrospectively identified and studied. Demographic variables, such as age and gender, were extracted from the clinical chart. Indirect immunoperoxidase staining was carried out for the progesterone receptor (PR) and Ki67. PR is analyzed as positive and negative, and the Ki67 proliferation index was determined. Results Thirty-two meningiomas from patients who underwent surgery were available for analysis. Twenty-five (78.1%) were positive for PR, 71.8% were females, and 93% were World Health Organization (WHO) grade I. Meningothelial (28%), fibrous (25%), and transitional (25%) meningiomas were the most frequent subtypes, correspondingly. The Ki67 mean value was 1.14 (0.11-10.71). Conclusion Our case series showed a greater frequency of meningiomas in women, with a high PR expression and a low Ki67 proliferation rate. These data correlate with literature worldwide.

Human papilloma virus genotypes in dysplasia and epithelial hyperplasia of oral cavity using the luminex xmap technology. A multicenter study

BACKGROUND: Oral cancer associated with high risk (HPV-HR) human papilloma virus (HPV) has been increasing. HPV-HR has been associated with epithelial dysplasia, however, little information exists on its frequency in epithelial hyperplasia lesions. The aim of this study is to compare HPV genotypes in dysplastic and hyperplastic lesions of oral cavity. MATERIAL AND METHODS: Two hundred and fifty oral lesions: 131 dysplasia and 119 hyperplasia from two regions of Colombia were evaluated. One hundred seventy-four coming from urban area and 104 from a high risk population to oral cancer from a rural area. HPV was identified by qPCR and Twenty-four HPVs genotypes were evaluated by Luminex(R) technology. Logistic regressions were performed to establish the associations between HPV infections with oral dysplasia. RESULTS: Twenty-eight percent (70/250) of the samples were positives for any HPV and HPV-HRs were more frequently than low risk HPVs. HPV-16 was the most detected genotype (16%) followed by HPV-31, 53, 18 and 45. HPV, HPV-HRs and HPV-16 were only associated with dysplasia in urban area; OR 3.28 (CI 95% 1.49-7.17), OR 7.94 (CI 95% 2.97-21.2) and OR 5.90 (CI 95% 2.05-17). Individuals in rural area showed more HPV and HPV-HRs infection in hyperplasic lesions than urban population. The majority of HPV+ lesions had multi-type of HPV (52/70) and the urban individuals showed more genotypes than rural population. CONCLUSIONS: HPV-.HRs are frequently found in hyperplastic and dysplastic epithelial lesions. HPV-HRs and HPV-16 were associated with dysplasia in urban population. Rural high risk population and urban population differ in the frequency and variety of HPV genotypes

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Necrotizing lymphocytic vasculitis limited to the peripheral nerves: report of six cases and review.

Background. The systemic vasculitides are syndromes characterized by inflammation and injury (necrosis or thrombosis) of blood vessels, resulting in clinical manifestations according to the affected vascular bed, but not classically in stocking-glove neuropathy. Objective. To describe a form of primary vasculitis affecting strictly peripheral nerves manifesting as stocking-glove neuropathy. Methods. Case series of 110 patients seen in three centers in Bogotá who presented with symptoms and signs of polyneuropathy and/or were identified with vasculitis affecting only the peripheral nerves, and who underwent sural nerve biopsy. Results. Six patients had a vasculitis affecting only the peripheral nerves diagnosed on sural nerve biopsy which demonstrated a mixed infiltrate of monocytes/macrophages and lymphocytes especially in the small epineurial blood vessels. Over time, all had worsening of symptoms, with grip weakness and motor deficits in the hand and feet. Serologies and acute phase reactants were normal in all patients. Treatment response to immunosuppression was satisfactory in 5 patients; 1 patient had progressive neurologic damage. Conclusions. There is a distinct form of primary vasculitis of the peripheral nervous system characterized by distal sensory polyneuropathy with stocking-glove distribution with good prognosis, few and minor relapses and good response to treatment even after delayed diagnosis.

Causes of unexpected death in patients with multiple sclerosis: a forensic study of 50 cases.

To determine the cause of death (as a result of neurologic or nonneurologic complications or accidents) in patients with multiple sclerosis (MS), we reviewed the autopsies of 50 subjects with MS from the Office of the Chief Medical Examiner of Maryland (OCME) between 1982 and 2004. The series included 32 females and 18 males (mean age, 45.8 years; range, 25-69 years) and the causes of death were classified into 3 categories: (A) neurologic complication directly related to MS; (B) nonneurologic complications or other medical causes; and (C) accidents, etc. Of the 50 cases, in 43 there was a history of MS, but in 7 subjects there was not, and the diagnosis was established by neuropathologic examination. In Group A, 21 (42%) cases, deaths were directly related to a neurologic complication; in Group B, 14 (28%) cases were related to the following nonneurologic and medical causes: ASCVD 9 (18%), metabolic disorder 1 (2%), pulmonary embolism 3 (6%), and bronchopneumonia 1 (2%); and in Group C, 15 (30%) cases, deaths were due to trauma, 9 (18%); intoxication, 5 (10%); and thermal injury, 1 (2%). Thus, among the 50 subjects, in 26, deaths occurred naturally; and in 24, from accidents, homicides, suicides, or undetermined causes. Pathologically, the majority of cases showed either chronic inactive (66.7%) or chronic active (15.6%) demyelinating lesions, mainly in the cerebral hemispheres. In some cases, it appears that demyelinating lesions, involving brain regions that regulate cardiorespiratory activity, could be considered as the immediate cause of death, but a large proportion appears to be due to other causes such as accidents and trauma. Thus, it seems likely that taking specific precautions could prevent some deaths in MS.

Neuropathology provides clues to the pathophysiology of Gaucher disease.

To better understand the pathogenesis of brain dysfunction in Gaucher disease (GD), we studied brain pathology in seven subjects with type 1 GD (four also exhibited parkinsonism and dementia), three with type 2 GD and four with type 3 GD. Unique pathologic patterns of disease involving the hippocampal CA2-4 regions and layer 4b of the calcarine cortex were identified. While these findings were common to all three GD phenotypes, the extent of the changes varied depending on the severity of disease. Cerebral cortical layers 3 and 5, hippocampal CA2-4, and layer 4b were involved in all GD patients. Neuronal loss predominated in both type 2 and type 3 patients with progressive myoclonic encephalopathy, whereas patients classified as type 1 GD had only astrogliosis. Adjacent regions and lamina, including hippocampal CA1 and calcarine lamina 4a and 4c were spared of pathology, highlighting the specificity of the vulnerability of selective neurons. Elevated glucocerebrosidase expression by immunohistochemistry was found in CA2-4. Hippocampal (45)Ca(2+) uptake autoradiography in rat brain was performed demonstrating that hippocampal CA2-4 neurons, rather than CA1 neurons, were calcium-induced calcium release sensitive (CICR-sensitive). These findings match recent biochemical studies linking elevated glucosylceramide levels to sensitization of CA2-4 RyaR receptors and 300% potentiation of neuronal CICR sensitivity. In two patients with type 1 GD and parkinsonism, numerous synuclein positive inclusions, similar to brainstem-type Lewy bodies found in Parkinson disease, were also found hippocampal CA2-4 neurons. These findings argue for a common cytotoxic mechanism linking aberrant glucocerebrosidase activity, neuronal cytotoxicity, and cytotoxic Lewy body formation in GD.

Encefalomielitis aguda diseminada multifásica: presentación de un caso en el Hospital Simón Bolivar / Acute disseminated encephalomyelitis: presentation of a case in the Hospital Simón Bolívar

Se presenta un caso de encefalomielitis aguda diseminada multifásica atendido en el hospital Simón Bolívar-Bogotá Colombia. La paciente acudió al servicio de urgencias en varias oportunidades por signos y síntomas de compromiso neurológico multifocal; su tratamiento inicialmente tuvo una orientación neuroinfecciosa. El curso clínico demandó una cuidadosa revisión de los estudios patológicos y de imagen llegando al diagnóstico la encefalomielitis, por lo que se instauró tratamiento con esteroides. Se discuten la etiopatogenia de la enfermedad, su presentación clínica y posible tratamiento

Metaplasia intestinal de la union esofagogastrica: prevalencia, relacion con reflujo gastroesofagico, Helicabacter pilori e histologia gastrica / Intestinal metaplasia of esophagogastric junction

El interés por la metaplasia intestinal especializada (MIE), de localización cardial, crece conforme se incrementa la prevalencia de adenocarcinoma de la union esofagogastrica. Se plantean diversas hipotesis que la asocian con la presencia de reflujo gastroesofagico y sus complicaciones, la actividad gastrica, la presencia de carditis y Helicobacter pylori, sin que hasta el momento se tenga confirmacion irrefutable de cada una de ellas. Si bien su prevalencia en paises como Estados Unidos y los de Europa es alta, 15 a 50 por ciento, no se conoce en nuestro medio. Objetivo: conocer la prevalencia de la MIE de localización cardial en una poblacion colombiana y establecer sus asociaciones con la presencia de reflujo gastroesofagico esofago de Barrett, carditis, histologia gastrica e infeccion por H. pylori. Materiales y metodos: el estudio se llevo a cabo en un municipio de 373.335 habitantes; para una prevalencia esperada de MIE de 20 por ciento; para una prevalencia esperada de MIE de 20 por ciento, se calculó una muestra de 265 pacientes, que fueron captados en forma consecutiva de aquellos remitidos por síntomas dispepticos a la unidad de endoscopia del hospital local. Antes del procedimiento endoscopico, se aplico un formulario donde se consignaban los datos de identificacion, los sintomas de reflujo gastroesofagico, su duracion en semanas y la frecuencia de presentacion en dias por semana...

Neuropatía sensitivomotora axonal aguda en un niño con recidiva de síndrome de Guillain-Barre / Acute axonal sensitive motor neurophathy in child with recidivant Guillain-Barre syndrom

Se presenta un niño con un episodio de debilidad muscular progresiva que comprometió las cuatro extremidades y cursó con insuficiencia respiratoria y disautonomía. Sus antecedentes incluían tres episodios de síndrome de Guillain-Barre. Se discute el diagnóstico diferencial en la clínica y en el laboratorio de neurofisilogía, en especial con la polineuropatía desmielinizante crónica y se analizan las diversas opciones de tratamiento para estos casos